Safety and efficacy of tocilizumab in COVID-19: A systematic evaluation of adverse effects and therapeutic outcomes
Rattachement africain : sa, Afrique du Sud. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: While COVID-19 has transitioned from a pandemic to an endemic state, the management of its persistent complications continues to present substantial clinical challenges. Tocilizumab, an interleukin-6 receptor antagonist endorsed by the World Health Organization (WHO) for severe COVID-19 management, remains a critical therapeutic intervention. This systematic evaluation provides a comprehensive assessment of tocilizumab's safety and efficacy profile to inform clinical decision-making. METHODS: The study involved exhaustive search across multiple databases (PubMed, SCOPUS, WoS, BIOSIS) utilizing MeSH terms and Boolean operators to identify relevant studies. Methodological worthiness was rigorously evaluated utilizing the Risk of Bias 2 (RoB 2) tool. The statistical analysis of the findings incorporated one-way ANOVA, Mann-Whitney U tests, and Pearson's correlation coefficient (r) with 95 % confidence intervals to quantify adverse effects and therapeutic outcomes. RESULTS: The analysis of nine studies encompassing diverse demographic populations (ages ≥2 years, both sexes) established a clear safety profile for tocilizumab. The treatment demonstrated a statistically important association (P < 0.05) with mild adverse effects (nausea, diarrhea, headache, fatigue; r = 0.62, 95 % CI = 0.59-0.71) and moderate adverse effects (tremors, urinary difficulties, mood changes; r = 0.54, 95 % CI = 0.47-0.60). More concerning were the severe adverse effects, including hepatobiliary dysfunction and hypersensitivity reactions (r = 0.36, 95 % CI = 0.32-0.41), with rare but critical instances of acute liver failure (r = 0.18, 95 % CI = 0.15-0.22). Notably, despite this safety profile, tocilizumab exhibited significant therapeutic efficacy (P < 0.01) in ameliorating COVID-19 symptoms, particularly in cases complicated by cytokine storm syndrome. CONCLUSION: This study confirms tocilizumab's position as a valuable therapeutic agent for COVID-19 complications while highlighting the necessity for judicious patient selection and vigilant monitoring due to its potential for significant adverse effects. The findings underscore the importance of pre-treatment screening, adherence to contraindications, and ongoing pharmacovigilance to optimize risk-benefit ratios.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Safety and efficacy of tocilizumab in COVID-19: A systematic evaluation of adverse effects and therapeutic outcomes
- Date Crossref
- 01/10/2025
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Shaqra University pays non établi dans la noticeUniversité ou école supérieure
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Qassim University pays non établi dans la noticeUniversité ou école supérieure
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Buraydah Colleges pays non établi dans la noticeUniversité ou école supérieure
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Northern Border University Center For Health Research pays non établi dans la noticeUniversité ou école supérieure
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University of Pretoria University of Pretoria, Afrique du Sud (code pays fourni par la source)Université ou école supérieure
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College of Pharmacy Department of Clinical Pharmacy pays non établi dans la noticeUniversité ou école supérieure
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College of Applied Sciences Department of Emergency Medical Services pays non établi dans la noticeUniversité ou école supérieure
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School of Health Systems and Public Health University of Pretoria, Afrique du Sud (pays nommé en fin d’affiliation)Université ou école supérieure
Shaqra University, Qassim University et Buraydah Colleges, avec 5 autres affiliations. Pays d’affiliation : Afrique du Sud.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.